Bayesian network Meta-analysis of traditional Chinese medicine pulmonary rehabilitation measures for improving pulmonary function and exercise tolerance in patients with stable phase of chronic obstructive pulmonary disease

Objective To systematically evaluate the efficacy of different traditional Chinese medicine pulmonary rehabilitation interventions on pulmonary function and exercise tolerance in patients with stable phase of. Methods Databases including CNKI, Wanfang, VIP, China Biology Medicine, PubMed, and the Cochrane Library were searched for randomized clinical trials (RCTs) related to chronic obstructive pulmonary disease from their inception to June 30, 2023. Two researchers independently conducted literature screening, data extraction, and bias risk assessment. Statistical analysis was performed using Stata 17.0 and R 4.4.1 software. Results A total of 239 RCTs involving 20, 719 patients were included, encompassing 18 types of interventions, such as acupoint application, acupuncture, moxibustion, traditional Chinese medicine exercises, massage, cupping, etc. Network Meta-analysis revealed that compared with conventional treatment, traditional Chinese medicine exercises, moxibustion, acupoint application, acupoint application plus auricular point pressing, acupoint application plus moxibustion, acupoint massage plus traditional Chinese medicine directed drug penetration, Chinese herbal footbath plus moxibustion, comprehensive traditional Chinese medicine rehabilitation, five-element music therapy, pulmonary rehabilitation training, and acupoint application plus acupoint injection significantly improved forced expiratory volume in the first second (FEV₁). Traditional Chinese medicine exercises, moxibustion, acupoint application, acupoint application plus moxibustion, Chinese herbal medicine, Chinese herbal footbath plus moxibustion, comprehensive traditional Chinese medicine rehabilitation, five-element music therapy, and acupuncture exhibited significant efficacy in reducing forced vital capacity (FVC). Traditional Chinese medicine exercise therapy, acupoint application therapy, acupoint application plus acupuncture therapy, acupoint application plus moxibustion therapy, and acupuncture therapy significantly enhanced exercise tolerance in patients (P < 0.05). The cumulative ranking plot demonstrated that Chinese herbal footbath plus moxibustion and acupoint application plus acupuncture were the most effective interventions for improving pulmonary function and enhancing exercise tolerance in patients with stable phase of chronic obstructive pulmonary disease. Conclusion Traditional Chinese medicine pulmonary rehabilitation interventions are effective in treating patients with chronic obstructive pulmonary disease, with each intervention demonstrating distinct advantages. Chinese herbal footbath plus moxibustion and acupoint application plus acupuncture may represent the optimal strategies for improving pulmonary function indices and enhancing exercise tolerance in patients with stable phase of chronic obstructive pulmonary disease.